Nevada Medicaid and Nevada Check Up News (Fourth Quarter 2019 Provider Newsletter) [Read]

Attention Behavioral Health Providers: Monthly Behavioral Health Training Assistance (BHTA) Webinar Scheduled [See Web Announcement 2009]

Attention All Providers: Requirements on When to Use the National Provider Identifier (NPI) of an Ordering, Prescribing or Referring (OPR) Provider on Claims [Announcement 850]

If you are a Medicaid provider whose revalidation application has not been processed by your termination due date, you will be ineligible to provide services to any Nevada Medicaid or Nevada Check Up recipients, including both Fee-for-Service and Managed Care Organization (MCO) enrolled recipients. See Web Announcement 1265

Enrollment Termination Frequently Asked Questions (FAQs) [Review]


Known Modernization System Issues-Click HERE

Paper claims are no longer accepted by Nevada Medicaid. Please refer to Web Announcement 1733 and Web Announcement 1829 for additional information.

Top 10 Claim Denial Reasons and Resolutions/Workarounds for January 2020 Claims. See Web Announcement 2103.

Top Prior Authorization Denial Reasons for the Fourth Quarter of 2019. See Web Announcement 2072.

Top 10 Enrollment Return Reasons and Resolutions for January 2020 Submissions. See Web Announcement 2092.

Attention Providers Using the Authorization Criteria Function: Results that return prior authorization (PA) requirements are accurate. For results that return “There are no records found based on the search criteria,” there may be a PA requirement if limits have been exceeded. To verify PA requirements, please refer to the Medicaid Services Manual (MSM) Chapter for your service type at and the Billing Guide for your provider type at

Scheduled Site Maintenance

During the scheduled site maintenance window the Provider Web Portal will be unavailable. The table below shows the regularly scheduled maintenance window. All times will be in the Pacific time zone.

Monday - Friday
12:00AM - 12:30AM

8:00PM - 12:00AM

Contact the Provider Training Unit

Provider Relations Field Service Representative Team Territories: Please refer to the attached document to determine which Field Representative is assigned to assist you with inquiries.

Nevada Medicaid and the Division of Health Care Financing and Policy (DHCFP)/Nevada Medicaid are committed to helping providers understand billing policy and successful claim submission. With these priorities in mind, we offer opportunities to increase your knowledge throughout the year in a variety of locations, formats and times, including lunch and learn sessions held during lunch hours to minimize time needed to be away from regular business hours. Instructor-led virtual training is also a great opportunity when travel is not possible, or when multiple staff from an office plan to attend.

Training is free of charge and we encourage the attendance of billing staff, billing agencies, direct practitioners/health care providers, office managers, admitting and front-desk staff, etc.

Provider training workshop schedules will be posted quarterly in a Web Announcement and on this webpage. Registration is required to attend the scheduled workshops. To register, simply select the 2020 Provider Training Registration Website link below, select the workshop of your choice, complete the required information and submit.

If you have difficulty registering, please send an email to our Provider Services Field Representative Team at Please include your name, contact information, and the workshop you are attempting to register to attend. A Field Representative will contact you to assist with the registration process.

In addition to the training workshops scheduled throughout the year, Provider Services Field Representatives are available in your area to assist when you have questions, concerns or additional training needs. As a reminder, the Annual Medicaid Conference is not a venue to discuss specific billing issues as they may include sensitive and confidential information. Please do not hesitate to reach out to your Field Representative as the need arises. If you are unsure who your representative is, please select the Provider Relations Field Service Representative Team Territories link and review Web Announcement 719 for additional details.

Training Calendar and Registration
Training Calendar
2020 Provider Training Registration Website
Training Announcements
Updated Date Title
Feb. 21, 2020 Attention Dental and Orthodontia Providers: Training Sessions Scheduled
Feb. 13, 2020 Attention Hospice Providers: Training Sessions Scheduled
Feb. 13, 2020 New Provider Orientation Scheduled for March 2020
Feb. 11, 2020 Attention Behavioral Health Providers: Training Sessions Scheduled
Feb. 6, 2020 Attention Provider Type 85 (Applied Behavior Analysis): Training Sessions Scheduled
Jan. 22, 2020 New Provider Orientation Scheduled for February 2020
Jan. 16, 2020 Provider Relations Field Service Representative Team Territories Update
Jan. 8, 2020 Attention All Provider Types: Claims Appeals, Adjustments and Voids Training Sessions Scheduled in 2020
Jan. 2, 2020 Attention All Providers: Revalidation and Changes Trainings Scheduled in 2020
Self-Paced Training

Self-paced, computer-based training courses available on demand for providers.

Group Code Training Portal
PROV Nevada Medicaid Training Portal
Date Topic
July 2017 Learning Management System (LMS) Tip Sheet

Serious Occurrence Report (SOR) Form Instruction Video
Provider Enrollment and Revalidation Instruction Materials
Date Topic
August 2019 Enrolling as an Individual Provider with Nevada Medicaid
August 2019 Enrolling as a Group with Nevada Medicaid
August 2019 Revalidating as an Individual Provider or Updating an Individual Provider’s Profile with Nevada Medicaid
August 2019 Revalidating a Contract or Updating a Profile as a Group Provider with Nevada Medicaid
August 2019 Enrolling as an Ordering, Prescribing or Referring (OPR) Provider with Nevada Medicaid
September 2019 Enrolling with Nevada Medicaid – Out-of-State Urgent/Emergency Individual Application
September 2019 Enrolling with Nevada Medicaid – Out-of-State Urgent/Emergency Group Application
Workshop Materials

Workshop materials will be posted to this site upon completion of the workshop.

Date Topic
February 2020 Electronic Verification System (EVS) Frequently Asked Questions (FAQ)
February 2020 Submitting an Institutional Claim for Medicare Part B Coverage - Tip Sheet
February 2020 The Life of a Claim Provider Training
November 2019 Community Paramedicine Provider Enrollment Training (Individuals)
November 2019 Community Paramedicine Provider Enrollment Training (Groups)
July 2019 National Drug Code (NDC): Billing for Physician Administered Drug (PAD) Claims
June 2019 Psychiatric Hospital, Inpatient (Provider Type 13) Provider Training
June 2019 Claims Appeals, Adjustments and Voids Provider Training | Tip Sheet for Claims Appeals
June 2019 Personal Care Services Provider Training (Provider Types 30 and 83)
April 2019 Therapy Provider Training
April 2019 Hospice Provider Training
April 2019 Dental and Orthodontia Provider Web Portal Provider Training
April 2019 Applied Behavior Analysis (ABA) Provider Training
March 2019 Reading a Remittance Advice (RA)
March 2019 Behavioral Health Provider Training
March 2019 New Provider Orientation
January 2019 Nevada Provider Training-Dental
January 2019 Nevada Provider Training-Professional
January 2019 Nevada Provider Training-Institutional
September 2018 Nevada Medicaid Nursing Facility PASRR/LOC Training
September 2018 PASRR and Nursing Facility LOC Frequently Asked Questions (FAQs)
June 2018 Adult Day Health Care (Provider Type 39) Provider Training
May 2018 Outpatient Mental Health Treatment Plan Fact Sheet
May 2018 Registered Dietitian (Provider Type 15) Provider Training
April 2018 Durable Medical Equipment (Provider Type 33) Provider Training
June 2016 Nursing Facility Tracking Form Validation Guide
June 2016 Nevada Medicaid Nursing Facility and ICF/IID Tracking Process Training
June 2016 ICF/IID Tracking Form Validation Guide
December 2015 PASRR Training
March 2015 Instructions for Requesting Roles, Approving Roles and Removing Users in the PASRR Web Portal
August 2015 ICD-10 Overview
September 2013 New Level Of Care (LOC) Screening Tool for PASRR Users
Annual Medicaid Conference Materials

Below are the materials presented at the Annual Medicaid Conference held in August and September of 2018.

2018 Medicaid Conference Main Presentation
Breakout Session: Behavioral Health
Breakout Session: Claim Appeals and Prior Authorization Submission
Breakout Session: Provider Enrollment and Program Integrity
Breakout Session: Long Term Services and Supports / Electronic Visit Verification System
Nevada MMIS Modernization Handout